High-Dose Intravenous Immunoglobulin as a Therapeutic Option for Deteriorating Patients With Coronavirus Disease 2019

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly in China. Until now, no definite effective treatment has been identified. We reported on 3 patients with severe COVID-19 who received high-dose intravenous immunoglobulin (IVIg) with satisfactory recovery. Based on these observations, randomized studies of high-dose IVIg should be considered in deteriorating patients infected with COVID-19.

Currently Available Intravenous Immunoglobulin Contains Antibodies Reacting Against Severe Acute Respiratory Syndrome Coronavirus 2 Antigens

“…Rather, the findings can be viewed as a base for further evaluation of IVIG to investigate its potential in vivo activity in functional tests such as neutralization assays. Even with this uncertainty, in the context of the current health emergency (pandemic), the potential of IVIG as a therapy for COVID-19 is already being evaluated in a number of studies involving patients with severe SARS-CoV-2 viral infections including pneumonia [28][29][30].…”

Currently available intravenous immunoglobulin (Gamunex®-C and Flebogamma®DIF) contains antibodies reacting against SARS-CoV-2 antigens

“…Altogether, these known immunomodulatory effects of IVIG products could be beneficial in COVID-19 disease management. Anecdotally, there was a case series report describing a positive effect of high dose IVIG in three patients with COVID-19 [24]. It should be noted that IVIG products are generally deemed safe and welltolerated.…”

Clinical Efficacy of Intravenous Immunoglobulin Therapy in Critical Patients with COVID-19: A Multicenter Retrospective Cohort Study

“…However, due to lacking specific antibodies against SARS-CoV-2, the efficacy of IVIG remains to be elucidated. It is noticed that use of IVIG is recommendation in the list of selective methods in the COVID-19 therapeutic guidelines of WHO [4,7,14,15].…”